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Building up immunization one dose at a time in southern Afghanistan

© UNICEF Afghanistan/2005/Mitani
Aziza, a volunteer vaccinator in Kandahar, immunizes a child against polio.

By Junko Mitani

KANDAHAR, Afghanistan, 22 February 2005 – Lialuma, a 26-year-old mother of six children, sits quietly holding her pale baby in her arms at the Out Patient Department Centre in Kandahar City, southern Afghanistan. “I’m afraid that he can’t be saved. I’ve already bought a piece of white cloth for his funeral. I’ve taken him to three doctors, but he is not getting better. This is the second child I’m going to lose,” says a desperate Lialuma.

In Afghanistan, one out of seven newborn babies dies within a year, and one out of five children die before their fifth birthday. “I’m here today to get my other children vaccinated. I heard on the radio that children won’t die if they get immunized. I was so happy when I listened to the announcement,” continues Lialuma.

Aziza, a vaccinator at the centre, vaccinates 50 to 80 children a day, free of charge. “I explain to every mother about immunization in simple language so that she can understand. I tell them to come back a month later, but some go back to the refugee camps in Pakistan and some go to villages. There is no system to track down those who dropped out of our vaccination cycle.”

Volunteer vaccinators

Without completing several vaccinations over a specified time period, a child can’t be fully protected against many preventable childhood diseases. Incomplete immunization rates are estimated at around 50 per cent in Afghanistan. Furthermore, many children in rural areas are not immunized at all, except against polio.

© UNICEF Afghanistan/2005/Mitani
Sixteen-year-old vaccinator Fatima, clad in a burqa, carries a cold box used for transporting vaccines.

“The biggest change after the Taliban was that, in consultation with UNICEF, we employed female volunteer vaccinators. Out of a total 552 volunteer vaccinators in Kandahar, 95 per cent are women,” explains Haji Nazar Mohammad, who is on the Regional Expanded Programme for Immunization management team. Mr. Mohammed has been working to immunize Afghan children for the last 25 years.

Sixteen-year-old Fatima is one of the female vaccinators. Her family came back to Afghanistan three years ago from Iran. Fatima gets a small amount of money to cover her expenses for the three-day work. She came to know about the opportunity one day while listening to the radio. “I’m glad that I can contribute to the eradication of polio in Afghanistan,” she says. “This is good for the future of our country.”

Strengthening routine immunization

UNICEF is supporting a ‘mop-up’ polio campaign in southern Afghanistan. As a result, the number of polio cases in the area has declined significantly, from 20 cases four years ago to just four in 2004.

UNICEF is now strengthening routine immunization against not only polio, but also diseases such as whooping cough, diphtheria, measles, pertussis, tuberculosis and tetanus. In order to support routine immunization and make sure that it is carried out effectively, there is a critical need for improved infrastructure, such as vaccine storage facilities.

On 5 January 2005, the southern regional vaccine storage facility, supported by the government of Japan and USAID and assisted by UNICEF, was inaugurated in Kandahar. The facility now stores 2 million vials of various vaccines, sufficient for immunizing 1 million children.

The vaccine facility is a visible reminder that despite insecurity, poverty and all the sorrow and pain caused by nearly three decades of conflict, the Afghan people have started to rebuild their lives step by step.



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